Methods and systems for lead movement detection and response in DBS therapy

Abstract

Methods and systems for detecting if a stimulation lead implanted in a patient's brain has moved. Lead movement occurring between a first time and a second time may be determined by comparing features extracted from evoked potentials recorded at the two times. The disclosed methods and systems are particularly useful for determining if a stimulation lead has moved between the time it was implanted in the patient's brain and the time that stimulation parameters are being optimized. Lead movement during implantation, during parameter optimization, and during or between other lead optimization processes may be determined as well.

What is claimed is: 
     
       1. A method for assisting a user to optimize an electrode lead configuration for providing deep brain stimulation (DBS) for a patient using an electrode lead implantable in the patient's brain, wherein the electrode lead comprises a plurality of electrode contacts, the method comprising:
 receiving parameters specifying a first stimulation location on the lead at which to provide stimulation, wherein the first stimulation location was previously determined using a first lead optimization algorithm, 
 receiving a first one or more values for one or more features extracted from recorded first evoked potentials (EPs) that were previously determined during the first lead optimization algorithm, 
 providing stimulation to the patient using the first stimulation location and recording second EPs evoked by the stimulation, 
 extracting a second one or more values for the one or more features from the second EPs, and 
 comparing the first and second one or more values to determine if the lead has moved since the first lead optimization algorithm was performed. 
 
     
     
       2. The method of  claim 1 , wherein the first and second EPs each comprise evoked resonant neural activity. 
     
     
       3. The method of  claim 1 , wherein comparing the first and second one or more values comprises determining a difference between the first and second one or more values and comparing the difference to a predetermined threshold value. 
     
     
       4. The method of  claim 3 , further comprising causing a user interface to display an indication that the lead has moved if the difference exceeds the threshold value. 
     
     
       5. The method of  claim 3 , further comprising using the indication of lead movement to determine whether to use the first stimulation location as an input for a second lead optimization algorithm. 
     
     
       6. The method of  claim 5 , comprising determining not to use the first stimulation location as an input for a second lead optimization algorithm if the difference exceeds the threshold value. 
     
     
       7. The method of  claim 1 , further comprising performing the first lead optimization algorithm. 
     
     
       8. The method of  claim 1 , wherein the first lead optimization algorithm comprises a lead implantation algorithm configured to assist a user to implant the one or more electrode leads in the patient's brain. 
     
     
       9. The method of  claim 1 , wherein the second lead optimization algorithm is configured to optimize a location on the electrode lead for providing stimulation. 
     
     
       10. The method of  claim 1 , wherein determining if the lead has moved comprises determining if the lead has moved longitudinally. 
     
     
       11. The method of  claim 1 , wherein determining if the lead has moved comprises determining if the lead has rotated. 
     
     
       12. A system for optimizing a stimulation lead implanted in a patient's brain, the lead comprising a plurality of electrodes, the system comprising:
 a graphical user interface, and 
 control circuitry configured to:
 receive parameters specifying a first stimulation location on the lead at which to provide stimulation, wherein the first stimulation location was previously determined using a first lead optimization algorithm, 
 receive a first one or more values for one or more features extracted from recorded first evoked potentials (EPs) that were previously determined during the first lead optimization algorithm, 
 cause stimulation circuitry to provide stimulation to the patient using the first stimulation location and record second EPs evoked by the stimulation, 
 extract a second one or more values for the one or more features from the second EPs, and 
 compare the first and second one or more values to determine if the lead has moved since the first lead optimization algorithm was performed. 
 
 
     
     
       13. The system of  claim 12 , wherein the first and second EPs each comprise evoked resonant neural activity. 
     
     
       14. The system of  claim 12 , wherein comparing the first and second one or more values comprises determining a difference between the first and second one or more values and comparing the difference to a predetermined threshold value. 
     
     
       15. The system of  claim 14 , wherein the control circuitry is further configured to cause the user interface to display an indication that the lead has moved if the difference exceeds the threshold value. 
     
     
       16. The system of  claim 15 , wherein the control circuitry is further configured to use the indication of lead movement to determine whether to use the first stimulation location as an input for a second lead optimization algorithm. 
     
     
       17. The system of  claim 15 , wherein the control circuitry is configured to not use the first stimulation location as an input for a second lead optimization algorithm if the difference exceeds the threshold value. 
     
     
       18. The system of  claim 12 , wherein determining if the lead has moved comprises determining if the lead has moved longitudinally. 
     
     
       19. The system of  claim 12 , wherein the control circuitry is further configured to determine a distance the lead has moved longitudinally. 
     
     
       20. The system of  claim 12 , wherein determining if the lead has moved comprises determining if the lead has rotated.